Corneal wound healing after laser in situ keratomileusis flap lift and epithelial abrasion

J Cataract Refract Surg. 2003 Oct;29(10):2007-12. doi: 10.1016/s0886-3350(03)00331-6.

Abstract

We report the clinical and confocal microscopic findings of wound-healing reactions after epithelium debridement and flap lift for the treatment of folds in a thin laser in situ keratomileusis (LASIK) flap. A 30-year-old woman had a flap lift with deepithelialization because of persistent striae after LASIK. The patient developed stage 2 diffuse lamellar keratitis (DLK) and dense haze. Confocal microscopy showed a loss of the most anterior keratocytes 6 days after flap relifting and deepithelialization. Subsequently, stromal repopulation with the appearance of spindle-shaped fibroblasts and activated keratocytes was detectable. Two months postoperatively, a maximum of haze tissue was found at the interface level and a myopic shift of -2.00 diopters was observed. Under treatment with topical steroids, the haze resolved and the spherical equivalent returned to baseline within 12 months.

Publication types

  • Case Reports

MeSH terms

  • Adult
  • Corneal Opacity / diagnosis
  • Corneal Opacity / drug therapy
  • Corneal Opacity / etiology
  • Corneal Stroma / drug effects
  • Corneal Stroma / pathology*
  • Debridement
  • Epithelial Cells / drug effects
  • Epithelial Cells / pathology
  • Female
  • Fibroblasts / drug effects
  • Fibroblasts / pathology
  • Fluorometholone / therapeutic use
  • Glucocorticoids / therapeutic use
  • Humans
  • Keratitis / diagnosis
  • Keratitis / drug therapy
  • Keratitis / etiology*
  • Keratomileusis, Laser In Situ / adverse effects*
  • Microscopy, Confocal
  • Reoperation
  • Surgical Flaps*
  • Wound Healing*

Substances

  • Glucocorticoids
  • Fluorometholone